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REGISTRATION FORM Monday, October 26, 2015 Blackhorse Golf Club, 12205 Fry Road, Cypress, TX 77433 10:00 a.m. Registration & Lunch 12:00 p.m. Shotgun Start Sponsorship Package Details Available online at www.cy-hope.org. Yes, I/we wish to participate in the Larry Dierker Celebrity Golf Classic benefiting Cy-Hope at the following level: Event Underwriter - $20,000 Double Eagle Sponsor - $15,000 Eagle Sponsor - $10,000 Beverage Sponsor - $5,000 Hole-in-One Sponsor - $5,000 Hall of Fame Sponsor - $4,000 Birdie Sponsor - $3,000 Foursome +1 - $1,900 Pin Sponsor - $500 Individual Player - $500 Hole Sponsor - $300 Contact Name Team Member Names: 1. 2. 3. 4. Company Name Address City Zip Phone Email Check in the amount of $ enclosed. (Check # ) Charge the amount of $ to this credit card: f Visa f MasterCard Credit Card # Exp Date Signature To register, please complete and fax to 713.937.9418, email to cy-hope@cy-hope.org, mail to Cy-Hope: 17401 Village Green Drive, Houston, TX 77040, or go to www.cy-hope.org. Cy-Hope is a 501(c)3 non-profit organization. The mission of Cy-Hope is to make life better for kids in Cy-Fair. A portion of your sponsorship is tax deductible. Thank you to our event sponsors and business partners!

Benefiting Cy-Hope Event Underwriter - $20,000 Exclusive - Only One Available 2 Teams of four golfers + celebrity at BlackHorse Golf Club for the event VIP Priority choice of celebrities for your teams Named Event Underwriter in media printing, signage and our website Recognition on the Event Sponsor board Logo acknowledgment on all printed promotional materials, media and signage - event Company link on Cy-Hope website promoting golf event Two (2) hole sponsorship signs One (1) Pin Hole flag, autographed by Larry Dierker Logo on adhesive floor mat banners throughout the course Logo and listing in sponsor directory This sponsorship level underwrites 1 Hope Center, offering homework help, life skills classes and a safe place for kids to come after school.

Double Eagle Sponsor - $15,000 2 Teams of four golfers + celebrity at BlackHorse Golf Club for the event Named Double Eagle Sponsor in media printing, signage and our website Recognition on the Double Eagle Sponsor board Logo acknowledgment on all printed promotional materials, media and signage - event Company link on Cy-Hope website promoting golf event Two (2) hole sponsorship signs One (1) Pin Hole flag, autographed by Larry Dierker Logo on adhesive floor mat banners throughout the course Logo and listing in sponsor directory This sponsorship level underwrites 230 Dual Credit Scholarships for at risk students in Cy-Fair ISD. Eagle Sponsor - $10,000 Team of 4 golfers + celebrity at BlackHorse Golf Club for the event Named Eagle sponsor in media printing, signage and our website Recognition on the Eagle Sponsor board Logo acknowledgment on all printed promotional materials, media and signage event One (1) Pin Hole flag, autographed by Larry Dierker Logo on adhesive floor mat banners in registration and dinner area Logo and listing in sponsor directory. This sponsorship level underwrites 80 at risk students the opportunity to experience summer camp at Camp Lemonade.

Beverage Sponsor - $5,000 Team of 4 golfers + celebrity at BlackHorse Golf Club for the event Named Beverage sponsor in media printing, signage and our website Company signage on all beverage carts Acknowledgment on all printed promotional materials, media and signage - event print Logo on adhesive floor mat banners in registration and dinner area Logo and listing in sponsor directory This sponsorship level provides backpacks of food for 1000 at risk students over the summer. Hole in One Sponsor - $5,000 Two Available Team of 4 golfers + celebrity at BlackHorse Golf Club for the event Named Hole in One Sponsor in media printing, signage and our website Acknowledgment on all printed promotional materials, media and signage - event print Logo on adhesive floor mat banners in registration and dinner area Two (2) hole sponsorship signs on two of the four Par 3 holes (Holes 7, 9, 14 and 16) Logo and listing in sponsor directory This sponsorship level provides backpacks of food for 1000 at risk students over the summer.

Hall of Fame Sponsor - $4,000 One team of four golfers (+ celebrity) at BlackHorse Golf Club for the event Recognition on our website and in the Dinner, Auction & Awards area Signage on one hole (excluding holes 7, 9, 14, or 16 or those selected by Event Underwriter) This sponsorship level provides 4 Cy-Fair ISD Title One schools with musical needs. Birdie Sponsor - $3,000 One team of four golfers (+ celebrity) at BlackHorse Golf Club for the event Recognition on our website and at Registration and Lunch area Signage on one hole (excluding holes 7, 9, 14, or 16 or those selected by Event Underwriter) This sponsorship level provides 20 students with a summer band or orchestra camp.

Foursome +1 - $1,900 One team of four golfers (+ celebrity based on availability) at BlackHorse Golf Club for the event Recognition on our website Recognition on our website Pin flag signed by Larry Dierker Pin Sponsor - $500 Individual Player - $500 each Come and enjoy a great day for a great cause! You ll join 3 other golfers at BlackHorse Golf Club for the event Signage on hole Hole Sponsor - $300

A few things we do to bring hope for a brighter future to the kids of our community: Feed over 1700 students each weekend who would otherwise have no food Delivered 62,886 bags of food in 2014, with 3,821 volunteer hours logged Serve over 100 children each week at our 2 Hope Centers offering homework help, recreation, arts and life skills classes Partnered with over 110 volunteers logging over 2500 hours at our Hope Centers in 2014 Award scholarships for Dual Credit classes and Certification to over 1500 students Send over 80 students to summer camp each year Assisted over 1000 children with Christmas gifts in 2014 Selected by Cy-Fair ISD as one of the 75 honorees for the district s 75th Anniversary Celebration Received Non-Profit of the Year by the Cy-Fair Chamber of Commerce for 2014